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GI > 1- upper GI > Flashcards

1- upper GI Flashcards

1
Q

what components of GI tract are in head?

A

oral cavity then pharynx

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2
Q

what components of GI tract are in neck?

A

pharynx then oesophagus

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3
Q

what components of GI tract are in chest?

A

oesophagus

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4
Q

what components of GI tract are in abdomen?

A

stomach, small intestine, most of large intestine and most of accessory organs of GI

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5
Q

what components of GI tract are in pelvis?

A

rectum and then anal canal

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6
Q

what joint opens your mouth?

A

temporomandibular joint (TMJ)

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7
Q

what 3 pairs of muscles close your jaw?

A
  1. masseter (from angle of mandible up to zygomatic bone -lateral aspect)
  2. temporalis muscle (from temporal fossa down to coronoid process of mandible)
  3. medial pterygoid (mirror image of masseter but on medial rather than lateral - runs medial of mandible )
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8
Q

what pair of muscles opens jaw?

A

lateral pterygoid (from condoid to pterygoid plates) - actually pulls mandible forwards which allows mandible to swing open

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9
Q

what nerves control the muscles that open + close the jaw?

A

mandibular division of trigeminal nerve - CN V3

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10
Q

what type of joint is temporomandibular joint?

A

modified hinge synovial joint

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11
Q

what is purpose of condylar process?

A

it’s on mandible and it’s purpose is to try and prevent jaw moving too far forward

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12
Q

what is the course of cranial nerve V3?

A

arises from pons, passes through foramen ovale and to muscles of mastication + sensory area (in lower part of face + skull)

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13
Q

what nerve fibers are carried in cranial nerve V3?

A

sensory + motor

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14
Q

what is oral vestibule?

A

like hallway into oral cavity

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15
Q

what is the oral cavity?

A

in between upper + lower dental arch. when mouth at rest - it’s pretty much fully taken up by tongue

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16
Q

what are palatine tonsils?

A

collection of lymph nodes trying to detect when things get into system

→tonsils sit in between 2 arches

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17
Q

what is the uvula?

A

dangly bit in middle of mouth

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18
Q

how many teeth are there if normal set of completely erupted?

A

32 teeth

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19
Q

what are the teeth in your mouth?

A

you have upper + lower dental arch (right and left of both)
- there are 8 teeth per area e.g. in right upper dental arch

1+2 = incisors
3 = canine
4+5 = premolars
6,7,8 = molars
(8 = wisdom tooth)

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20
Q

what are the 3 major paired salivary glands?

A
  1. parotid (at ear)
  2. submandibular (under mandible and wraps around back) - also called whartons duct
  3. sublingual (underneath tongue)
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21
Q

how many salivary glands do you have?

A

loads - but i just need to know 3 major pairs (parotid, submandibular, sublingual)

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22
Q

what is the largest salivary gland? and what is it’s route for secretion?

A

parotid gland - secretes through duct that pierces through cheek muscle (buccinator muscle)

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23
Q

before putting anything in patients mouth for endoscope what is important to ask?

A

if any loose teeth or recent dental work to prevent aspiration

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24
Q

what nerve supplies the superior half of mouth + oral cavity?

A

CN V2 = maxillary division of trigeminal nerve

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25
Q

what nerve supplies the inferior half of the mouth?

A

CN V3 = mandibular division of trigeminal nerve

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26
Q

what is the
a) superior half
b) inferior half
of mouth?

A

a) gingiva (gums) of oral cavity + palate
b) gingiva (gums) of oral cavity and floor of mouth

27
Q

what part of the mouth is most sensitive to touch?

A

posterior wall of oropharynx is extremely sensitive to touch

28
Q

what nerve supplies the posterior wall of oropharynx?

A

CN IX (glossopharyngeal)

29
Q

what is the purpose of gag reflex - what nerves are involved?

A

it’s there as a protective reflex

CN IX = carries sensory part
CN IX + CN X = carry motor part

  • they work together to constrict the pharynx in attempt to close off
30
Q

what is course/route of CN V2? and what nerve fibers does it carry?

A

maxillary division of trigeminal nerve

coming form pons but goes through foramen rotundum and only carries sensory innervation - supplied mid part of face

31
Q

what nerve fibers does CN IX carry?

A

special sensory, sensory, motor, visceral afferent + parasympathetic

32
Q

what is course of CN IX?

A

From medulla then through jugular foramen to posterior wall of oropharynx (sensory), parotid gland (secretomotor) and post. 1/3rd Tongue (Sensation and Taste)

33
Q

what are the divisions of the tongue?

A

think like from side view
- anterior (2/3), it’s like top 2/3
- posterior (1/3), like bottom 1/3

34
Q

where is
a) anterior of tongue
b) posterior of tongue

A

a) classed as in oral cavity (think like top 2/3 of tongue)
b) not classed as oral cavity, in oral pharynx (think like bottom 1/3 of tongue)

35
Q

what nerves supply anterior of tongue?

A

general sensation = supplied by CN V3
special sensation(taste) = supplied by VII (facial nerve)

36
Q

what nerves supply posterior tongue?

A

general + special sensory supplied by CN IX

37
Q

what nerve fibers do CN VII carry?

A

special sensory, sensory, motor, parasympathetic

38
Q

what is route of CN VII?

A

in internal acoustic meatus (bony canal located within intemporal bone,is a passageway for many important structures related to hearing and balance). CN VII then comes out the stylomastoid foramen, it then splits in 2:

  1. passes through atiomo mastoid foramen, just to stimulate muscles for moving your face
  2. little branch = the chorda tympani branch (passes over tympani, eardrum) of CN VII hitches a ride with lingual branch of CN V3 so contains taste and parasympathetic axons for salivary glands
39
Q

what does CN VII supply?

A

-the muscles of facial expression
- the chorda tympani branch (which comes off CN VII and joins CN V3) supplies the sublingual salivary gland and submandibular salivary gland

40
Q

what nerves supply tongue muscles?

A

all supplied by CN XII (hypoglossal) except palatoglossus as part of palate so supplied by CN XI

41
Q

what are the 4 pairs of extrinsic tongue muscles?

A
  1. palatoglossus (from palate)
  2. styloglossus (from styloid process)
  3. hyoglossus (hyoid bone)
  4. genioglossus (genial tubercles)
42
Q

what is example of intrinsic tongue muscle?

A

Superior longitudinal muscle,Inferior longitudinal muscle, Transverse muscle

43
Q

what is an extrinsic tongue muscle?

A

start externally and then insert onto tongue- these ones move position of tongue

44
Q

what is an intrinsic tongue muscle?

A

purely found in tongue - all attachments in tongue - these ones change shape of tongue

45
Q

what is course of CN XII?

A

from medulla then through hypoglossal canal to extrinsic + intrinsic muscle of tongue (except palatoglossus)

46
Q

what nerve fibers are in CN XII?

A

only motor

47
Q

where is upper oesophageal sphincter?

A

cricopharyngeus = C6
once past this muscle your in oesophagus

48
Q

what is midline raphe?

A

where 2 sides of the pharyngeal wall are joined together posteriorly

49
Q

what are muscles on posterior neck?

A
  • inner layer of longitudinal muscles
  • superior, middle and inferior circular/constrictor muscles = they overlap each other like cups and contract from superior, medially and then inferior
50
Q

what nerves supply constrictor muscles on posterior of neck?

A

CN X

51
Q

what happens when contraction of posterior muscles of pharynx?

A
  • Contraction of these muscles shortens the pharynx and narrows its diameter, assisting in the peristaltic movement of the bolus of food or liquid downward toward the esophagus.
  • Additionally, the superior pharyngeal constrictor muscle also contributes to closing the nasopharynx, preventing food or liquid from entering the nasal cavity.
52
Q

how do you insert endoscope? i.e you have to get patient to swallow, what is this process?

A
  1. tongue pushes bolus of food towards oropharynx (voluntary)
  2. soft palate elevated + larynx elevated closing laryngeal inlet (involuntary)
  3. circular layer of pharyngeal constrictor muscles contract (involuntary)
  4. bolus of food enters oesophagus and travels inferiorly by peristalsis (involuntary)
53
Q

what normal constriction can occur in oesophagus causing problems swallowing?

a) cervical constriction?
b) thoracic constriction?
c) diaphragmatic constricion

A

a) contraction of cricopharyngeus muscle (upper oesophageal sphincter)
b) arch of aorta + left main bronchus
c) result of passing through diaphragm (lower oesophageal sphincter)

54
Q

what level does oesophagus start?

A

vertebral level C6 - at inferior edge of cricopharyngeus muscle

55
Q

what is the upper and lower oesophageal sphincter?

A

upper oesophageal sphincter is actual anatomical sphincter = cricopharyngeus muscle

lower oesophageal sphincter is just physiological (when passing through diaphragm)

56
Q

where and what is oesophageal plexus?

A

= contains parasympathetic nerves (vagal trunks) and sympathetic nerves which influence enteric nervous system to speed or slow peristalsis

  • they run on surface of oesophagus to supply smooth muscle within walls (distally)
57
Q

what nerve fibre influences enteric nervous system to speed up peristalsis?

A

parasympathetic

58
Q

what nerve fibre influences enteric nervous system to slow down peristalsis?

A

sympathetic

59
Q

where does oesophagus run?

A

starts in root of neck and runs posterior to trachea and anterior to vertebral bodies - then in chest runs posterior to heart - then in abdomen goes through diaphragm and immediately connects with stomach

60
Q

what are the factors that make lower oesophageal sphincter effect?

A
  • Contraction of diaphragm
  • Intra-abdominal pressure slightly higher than intragastric pressure so helps close off oesophagus at bottom
  • Oblique angle at which oesophagus enters the cardia of stomach(prevents reflux back into oesophagus)
61
Q

what is z-line?

A

very clear change in mucosa = just superior to gastro-oesophageal junction

62
Q

where does stomach lie?

A
  • across 3 regions of abdomen
  • Lies mainly in the left hypochodrium, epigastric and umbilical regions when the patient is supine
  • Is said to be ‘J’ shaped
63
Q

what are the different structures of stomach?

(cardia, fundus, body, rugae, incisura angularis, pyloric sphincter)

A

cardia = the tube where oesophagus goes into stomach
fundus = superior part
body = main area
rugae = series of ridges produced by folding of wall of organ
incisura angularis = angular notch in lesser curve of stomach
pyloric sphincter (pylorus) = 1st part of duodenum
pyloric antrum = region between the sharp indentation at the lower third of the stomach (incisura angularis) and the junction of the pylorus with the duodenum

GI (56 decks)

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